Breast Cancer and African American Women
Breast cancer is the most common cancer diagnosis among African American women, and among women nationwide.1 Studies have shown that when African American women follow the same preventive measures as white women, their death rates from breast cancer are very similar. However, African American women are more likely than white women to be diagnosed at later stages of the disease and are more likely to die from it. Scientists are still exploring the reasons behind these trends.
The incidence of breast cancer among African American women is slightly lower than it is for white women. In any given year, 95 out of 100,000 African American women are diagnosed with breast cancer, compared to 112 out of every 100,000 white women.2 However, African American women are slightly more likely to develop breast cancer before age 50, and white women are more likely to develop breast cancer after age 50. The graph below displays the trends.
Breast cancer is the cancer with the second highest death rate for both African American women and American women nationwide. The overall lifetime risk of being diagnosed with breast cancer is 10.14% for African American women and 13.83% for white women.3 However, about 31 out of every 100,000 African American women die from the disease each year compared to just 27 out of every 100,000 white women.2 In addition, while the death rate from breast cancer went down by 5% for white women from 1989 to 1992, it rose by 2% for African American women during the same period.4
Reasons Behind Racial Differences
A number of studies have looked into the question of why the breast cancer mortality rate is higher for African American women than white women. They have looked at whether breast cancer affects African American women differently than it does women of other races. The results are not conclusive. Some studies show no basic differences across races.3 However, a recent study found tumor cells in African American women growing more rapidly, and concluded that this could lead to more aggressive cancers at an earlier age. This study also found that African American women may be less responsive to hormone treatment.5
Statistics show that overall, when African American women are diagnosed, they have larger tumors and their breast cancer has spread further (i.e. to the lymph nodes and to other parts of the body).6 This is unfortunate because when breast cancer is discovered at more advanced stages, it is more difficult to treat, and survival rates are lower.
The five-year breast cancer survival rate for African American women is 69%, whereas it is 84% for white women.7 Overall, the past 5 years have seen an increase in the number of women who undergo hand-examinations by their doctors and mammograms to check for lumps in their breasts. However, African American women have fewer mammograms than white women and are likely to be diagnosed after the cancer has spread.
Researchers have shown that African American women who have regular mammograms have the same excellent chances of surviving breast cancer as all other groups of women.6 Tumors found early can be more easily treated and are more likely to be cured. Click here to learn about other methods of detecting breast cancer and the symptoms to look for in a breast self-exam.
All states and territories of the United States have programs that cover the cost of mammograms when insurance does not. Contact the American Cancer Society at 1-800-ACS-2345 to find the locations of these services in your community.
African American women may be less likely to undergo appropriate treatment because of a higher frequency of low income, single parent households. Consider the following:
- Time – Breast cancer treatment is both time consuming and draining. Women, who are often used to taking care of others, need to instead be taken care of while they complete treatment.
- Cost – Breast cancer treatment can be expensive, even if insurance covers the actual costs of treatment. There can also be additional travel costs, childcare costs, or costs for general home upkeep. Women may also lose wages when they miss work.
- Undertreatment – African American women are less likely to receive appropriate treatment, according to a study published in the American Journal of Public Health. Whether they were young or old, in early or late stages of breast cancer, African American women were more likely than white women to go untreated by physicians and to be treated by non-surgical methods.8
For low-income women running single parent households, the above considerations are real barriers to receiving full treatment and to surviving breast cancer. Click here to learn more about available treatments.
More studies of breast cancer treatments are urgently needed, especially of African American women, to make sure that these treatments are equally effective in this community. There must be increased access to appropriate prevention, detection and treatments for African American women.
National Black Women’s Health Project
1211 Connecticut Ave. NW Ste. 310
Washington, D.C. 20036
A national grassroots advocacy organization with local chapters and self-help groups.
African American Breast Cancer Alliance
P.O. Box 8981
Minneapolis, MN 55408
A member supported advocacy and support group for women with breast cancer. Includes regional and national networks.
1 National Institutes of Health, National Cancer Institute, Cancer Statistics Branch, 2000
2 “African American Women: Breast Cancer and Mammography Facts.” Cancer Facts. National Cancer Institute, National Institutes of Health. Update printed May 1996. 3 Ries LAG, Eisner MP, Kosary CL, Hankey BF, Miller BA, Clegg L, Edwards BK (eds). SEER Cancer Statistics Review, 1973-1998, National Cancer Institute. Bethesda, MD, 2001.
4 Health, United States 1994. National Center for Health Statistics 1995.
5 Siegel, R et al. “Survival of Black Women with Stage I and Stage II Breast Cancer is Inferior to Survival Among White Women When Treated the Same Way at a Single Institution.” Proceedings of the Annual Meeting of the American Society of Oncology; 13:A75, 1994. 6 Office on Women’s Health in the Department of Health and Human Services, 1998
7 Wells, BL and Hormk, JW. “Stage at Diagnosis in Breast Cancer: Race and Socioeconomic Factors.” American Journal of Public Health. Vol. 82, No. 10, October 1992, pp. 1383-1384.
8 McWhorter, WP and Mayer, WJ. “Black/White Differences in Type of Initial Breast Cancer Treatment and Implications for Survival.” American Journal of Public Health. Vol. 77 No.12, December 1987, pp. 1515-1516.
A racially diverse, volunteer panel of health and other professionals from throughout Ohio reviewed this document. Panel members offer their perspectives on NetWellness content developed for African Americans prior to posting.
This breast cancer information has been brought to you with help from the National Action Plan on Breast Cancer.
For more information:
Go to the Breast Cancer health topic.